These are extraordinarily difficult times for insurers to grow their business, with the United States and Europe struggling to jump-start their economies and a double-dip recession still not out of the question.

But the economy isn't the sole obstacle confronting carriers. They also face the more fundamental need to change how the industry does business to meet rapidly evolving consumer expectations in terms of products, distribution, service and technology.

To succeed in this demanding environment, insurers will need to come up with creative strategies to generate growth. At the same time, they must keep striving to improve operational excellence to squeeze costs out of the system and adapt to regulatory reforms.

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